Provider Demographics
NPI:1679310437
Name:EDEN ALLIED SERVICES LLC
Entity type:Organization
Organization Name:EDEN ALLIED SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWUYI ADEROUNMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-821-1460
Mailing Address - Street 1:1715 PEACHTREE LANE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:301-821-1460
Mailing Address - Fax:
Practice Address - Street 1:1715 PEACHTREE LANE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721
Practice Address - Country:US
Practice Address - Phone:301-821-1460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care